Universal health coverage needs our commitment to equality
In SA, November is National Disability Rights Awareness Month and internationally December 3, is the International Day of Persons with Disabilities.
But, in a world that strives for inclusivity and equitable healthcare access for all, the challenges faced by people with disabilities remain a stark reminder of the long road ahead. Global and national data consistently reveal that individuals with disabilities have heightened healthcare needs compared to the general population.
Yet, they continue to encounter an array of barriers that prevent them from receiving the medical attention they require.
Several significant barriers impede access to healthcare for individuals with disabilities. First, there’s the issue of inaccessibility.
Many healthcare facilities lack the essential features that would make them accessible to people with disabilities, such as ramps, doors, toilets with wheelchair access, Braille information and sign language interpretation.
This lack of accessibility makes it extremely difficult for individuals with disabilities to even enter healthcare facilities, let alone receive the care they need.
The second barrier is the unaffordability of services.
People with disabilities often bear additional costs related to their conditions, including specialist transport expenses and additional care and support.
However, they tend to be on average poorer than those without disabilities. While disability grants may provide some financial relief, they are often insufficient to cover the extra expenses associated with addressing disability-related needs.
Another critical issue is the scarcity and inequitable distribution of disability-specific care services. In SA, for example, the number of registered physiotherapists and other generalist rehabilitation services falls well below the standards seen in countries like the US and Australia. Moreover, these services are often unevenly distributed, with rural areas suffering the most.
The concept of universal health coverage promises that everyone should be able to access all the health services they need without facing financial hardships.
However, the existing disparities in healthcare access for people with disabilities, who constitute a substantial 16.1% of SA’s population, must be addressed if universal health coverage is to be a meaningful reality.
To achieve this goal, we need better data that helps us understand the causes and impact of disability and the specific vulnerabilities faced by individuals with disabilities.
This data will enable us to identify tangible solutions to enhance the delivery, monitoring, and evaluation of healthcare services, ensuring that these services are inclusive, accessible, and responsive to the needs of people with disabilities.
The South African Medical Research Council , an entity under the national department of health dedicated to improving the health of people in SA through research, has begun transforming itself into a disability-inclusive institution, contributing to the quest for improved healthcare access for individuals with disabilities.
Notably, its gender and health research unit (GHRU) is leading the Sub-Saharan team of the Disability Data Initiative (DDI), which aims to advance the rights of people with disabilities and promote sustainable human development by analysing existing data sets with disability-related questions.
This initiative provides valuable insights into the multidimensional poverty experienced by individuals with disabilities, with varying degrees of impact based on gender and geographical location.
The recent DDI 2023 report reveals that people with disabilities are disproportionately affected by income, education and health-related poverty.
Moreover, it highlights the differences in multidimensional poverty experienced by people with disabilities in different South African provinces.
The report also underscores that HIV, mental health, musculoskeletal, neurological and sensory organ disorders are the top contributors to Years Lived with Disability (YLD) in SA. This vulnerability to YLD, coupled with health disparities and multidimensional poverty, makes it imperative to provide disability-accessible healthcare services and better integrate disability and rehabilitation services into primary healthcare.
While people with disabilities report numerous barriers to healthcare access, data on the accessibility of public health facilities remains limited. To bridge this gap, the GHRU has developed and tested an action-oriented tool called the disability awareness checklist . This tool assesses the level of disability accessibility and inclusion in primary healthcare clinics, providing a practical intervention menu for SA and other countries.
Better data is an essential first step in understanding and addressing the healthcare disparities faced by individuals with disabilities.
To achieve universal health coverage and fulfil the promise of equitable healthcare for all, we must commit to improving healthcare access, making facilities more accessible, addressing financial barriers, and delivering disability-specific care where needed.
This is not only a matter of social justice but a reflection of our commitment to inclusivity and the betterment of society as a whole.
Author: Tendani Tsedu
Tsedu is the Head of Corporate & Marketing Communications at the South African Medical Research Council
Original Article available on the Sowetan Live